Tag: Coronavirus – a global health emergency

Wuhan Coronavirus: Akin to normal flu, can spread during the incubation period even before the onset of symptoms.

On 28th Jan 2020, the German Health Ministry confirmed that a 33-year-old German had contracted the virus from a Chinese colleague who had visited the company a week ago. The incubation period seems to be unusually long — up to two weeks. Therefore, it is possible that the Chinese colleague had no symptoms at the time. On her flight back home on 23rd Jan, the woman began to fall ill. She sought medical treatment after reaching China and tested positive for coronavirus. The information was shared with the German company, and the 33-year-old German also felt like he had flu and subsequently tested positive for the virus. Three more co-workers of the Chinese woman in Germany tested positive eventually.

“As the death toll from the novel (new) coronavirus or Covid-19, detected in Wuhan China touches 1,771(most of them in central Hubei province), the number of confirmed cases of pneumonia caused by the same novel coronavirus has mounted to about 70,617 in 31 provincial-level regions so far,” says China’s National Health Commission. City of 11 million people, the epicenter of the epidemic, continues to remain under virtual lockdown, while other major Chinese cities are facing severe travel restrictions.

Elsewhere in the world, the Philippines, Hong Kong, Japan, France, and Taiwan confirm a one each death due to novel coronavirus infection.

The virus apparently emerged from illegally traded wildlife (bats and snakes) at a seafood market in Wuhan that also sold live animals, crossed species to infect humans, and has further spread through human-to-human contact.

Bats and snakes are special meals (delicacies) eaten in some parts of China.

The 2019 n-CoV behaves like SARS, with bats likely as their primary reservoir, and spreads through large droplets predominantly from people having lower respiratory infections.

In a breakthrough, scientists in Australia have reportedly grown an exact copy of the coronavirus in a lab from the sample of an infected individual. The breakthrough would help researchers globally in their efforts to develop a vaccine and detection tests.

This new virus seems to grow better in primary human airway epithelial cells as compared to standard tissue-culture cells in the lab. This is what sets it apart from other viruses like SARS and MERS, making it harder to contain/quarantine.

India now has three confirmed cases in the southern state of Kerala in the students studying in Wuhan China.

Amidst all the chaos, there is a need to debunk some of the misconceptions around the disease and raise awareness to avoid panic.

It is not NEW!!

Every decade, a zoonotic (animals -> humans) coronavirus seems to cross species and infects humans. In this decade, this virus is the 2019-nCoV (Novel coronavirus). The name ‘corona’ is derived from its shape, resembling a crown or solar corona (the halo around the sun), when seen under an electron microscope. The virus appears round in shape with spikes poking out from its periphery.

The three deadly human respiratory coronaviruses that have been identified so far include:

Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV): in 2002

Middle East Respiratory Syndrome Coronavirus (MERS-CoV): in 2014

2019-nCoV— 75%-80% identical to the SARS-CoV in behavior

People infected with these coronaviruses have a severe inflammatory response in their respiratory tract. Going by the present numbers, the new virus has now infected more people in China than the 2002-2003 SARS outbreak.

Fatality is thankfully lower than SARS, MERS, and EBOLA. The estimated mortality rate so far is closer to 3% as against 10% in SARS, 33% in MERS and 50% for Ebola.

The designation came as the first person-to-person transmission of the virus got reported in the U.S. on Thursday, the 30th of Jan.

“Our greatest concern is the potential for the virus to spread to countries with weaker health systems,” WHO chief Tedros Adhanom Ghebreyesus said as he announced the virus as a Public Health Emergency of International Concern (PHEIC).

The virus has been traced to bats in Wuhan China. Snakes hunt for bats and reports suggest that snakes were being sold in the local seafood market in Wuhan. This increases the likelihood that the 2019-nCoV might have moved from bats to snakes and then to humans at the outset of the outbreak. It is still unclear though how the virus could adapt to both the cold-blooded (snakes) and warm-blooded (bats and humans) hosts.

Symptoms

Novel coronavirus (nCoV) is a large family of viruses that can cause a range of respiratory illnesses from the common cold to more dangerous conditions such as severe acute respiratory syndrome or SARS.

The incubation period is up to 2 weeks, according to WHO.

Most infected patients experience milder symptoms such as sneezing, running nose, dry cough, sore throat along with headache, malaise and/or fever lasting for a couple of days, but few have a severe illness, including pneumonia and respiratory failure. The principal cause of breathlessness in them is the fact that the virus does not attack the throat alone. It attacks the lung tissue as well. A few may experience nausea and/or vomiting and diarrhoea too.

According to a report published in the Lancet, one-third of the patients landed up in the intensive care unit; and around 15% of these succumbed to the infection. Almost all presented with fever, more than two-thirds had a cough and nearly 50% had weakness or muscle ache. More than 50% had shortness of breath.

The illness is highly contagious. Transmission occurs through large droplets and physical contact with the infected individual and less frequently from people with mild, nonspecific signs. The disease can also spread through fomites (surface transmission through clothing, beddings, doorknobs, railings, currency notes, etc.)

The infection is all over…

Closer to 750 cases have been reported in more than two dozen other countries – including Australia, Britain, France, Germany, Spain, Canada, United States, Russia, India, Japan, Hong Kong, Malaysia, Philippines, Macau, Nepal, Singapore, Taiwan, South Korea, Thailand, Vietnam, and Africa. The United States, Germany, Japan, Thailand, Vietnam, and South Korea have recorded a person-to-person transmission of the infection, suggesting a greater potential for spread.

Treatment

“The Coronavirus influenza outbreak this time is very very serious & fatal,” says the Ministry of Health in an emergency notification to the public. The virus causing it is very potent. No proven antiviral treatment exists yet for the causative coronavirus. (A combination of lopinavir and ritonavir exhibited some promise in patients with SARS, but this was only in the lab and not in humans). In the absence of any available specific treatment, the current focus is primarily on alleviation of symptoms like fever, dry cough, and shortness of breath.

Antibiotics will not work on coronavirus since it is a viral infection. However, if you are hospitalized for 2019-nCoV, you may receive antibiotics since bacterial co-infection is possible.

Good News!!

Chinese government confirms successfully curing its first patient of the deadly Wuhan Coronavirus using HIV Drugs.

Homoeopathy can help in the prevention

“Homoeopathy can be effective in the prevention of novel coronavirus infections”, says AYUSH ministry of the country through an advisory following a meeting of the scientific advisory board of the Central Council for Research in Homoeopathy (CCRH) under the Ministry of AYUSH, to discuss ways and means for the prevention of the nCoV infection through Homoeopathy.

It has recommended the use of homoeopathic medicine Arsenicum album 30 as a prophylactic medicine against the infection. You can get in touch with your Homoeopathic physician for more details.

The advisory further suggested general hygienic measures for the prevention of the air-borne infection such as —

maintain personal hygiene.

clean hands often with alcohol-based hand rub or soap and water for at least 20 seconds.

avoid touching your eyes, nose, and mouth with unwashed hands.

avoid close contact with people who have fever and cough.

cover your mouth and nose while coughing or sneezing.

avoid going to crowded places.

use an N95 mask while traveling or working in public places to avoid droplet transmission.

“If you suspect Corona Viral infection, wear a mask and contact your nearest hospital immediately,” the advisory said. It also recommended prophylactic measures/ immunomodulatory drugs as per Homoeopathic/Ayurvedic practices and take measures to strengthen the immune system through a healthy diet and lifestyle practices such as —

Do not consume junk and/or non-veg food.

Avoid fried or spicy food and load up vitamin C and B complex daily.

A decoction of Tulsi, Ginger, Pepper, Curcumin in hot water helps immensely.

Guduchi (giloy) treats fever & enhances immunity.

Take hot vegetable soups or sip-in hot water.

Do not hold your thirst. Always keep your throat moist because once the membrane in your throat gets dry, the virus will invade into your body faster (Approx. 50-80cc warm water for adults, 30-50cc for kids).

Avoid any form of cold drinks, ice creams, milkshake, raw ice, ice colas, milk or sweets older than 48 hours, and preserved foods for at least the next 90 days.

Consumption of raw or undercooked animal products should be avoided. Raw meat, milk or animal organs should be handled with care to avoid cross-contamination with uncooked foods.

If you experience the TRIO– fever, cough and difficulty breathing – seek medical help immediately, esp. if you have a previous travel history or came in contact with a person with a recent travel history. Do not forget to mention it to your health provider.

The Way Forward…

quarantining for two weeks of the LRTI (lower respiratory tract infection) patients, and

timely diagnosis is the need of the hour.

PMO Suggestions In Chronology

17th Jan: India at the threat of Coronavirus. Advisory should be issued

18th Jan: Indian government issues travel advisory as China’s mysterious Coronavirus spreads in other countries

22nd Jan: Still not being declared to be a notifiable disease; N 95 to be included in the list of essential drugs and price-capped; Oseltamivir should also be price-capped; flights should have masks available for all passengers; not declaring flu-like symptoms while boarding or landing should be a punishable offense (23rd Jan: India advisory to airports)

Thermal screening at the airports as an offshoot of the travel advisory by various countries.

24th Jan: Inter-Ministerial Committee needs to be formed on Coronavirus (PMO took a meeting on 24th evening)

25th Jan: Indian government should pay for Indians affected by the virus in China

26th Jan: Need of National Droplet Infection Control Program; Policy to ban the export of face masks; policy to evacuate Indians from China’s affected areas; Time to collaborate on Nosode therapy

27th Jan: Anti-fever drugs at airports should be taken

28th Jan: Do research on Nosodes.

“The situation is being closely monitored by the Ministry of Health and Family Affairs, in coordination with various other Union ministries as well as state governments and Union Territories”, assure the officials at the PMO. The sources said the National Institute of Virology labs are fully equipped to test the virus and that all state and district health authorities have been put on alert.

As of Feb 14, 2325 flights and 2,51,447 passengers have been screened at 21 Airportsacross the country. 9,452 persons were put under community surveillance in 32 states and UTs as of February 10. Out off the 1,510 samples tested, 1,507 of them were found negative except for 3 samples which had tested positive already from Kerala to date.

“PM Modi is personally monitoring the situation arising out of Coronavirus spread. People coming in from 6 countries, China, Thailand, Hong Kong, Singapore, Japan & South Korea are being screened at 21 airports, to ensure that the virus does not make inroads into India,” says Health Minister Harsh Vardhan.

Screening Wards In India

The virus can be tested in a laboratory through a Real Time-PCR, followed by gene fingerprinting. In India, 15 labs are functional to test the novel coronavirus so far. “Nineteen will be made operational soon,” said Union health minister Dr Harsh Vardhan.

In Delhi: Manesar camp is already monitoring those who have come from China. Ram Manohar Lohia, AIIMS and Safdarjung hospitals in the capital have also readied isolation facilities.

In Mumbai: Two Mumbai hospitals namely, Kasturba hospital and Pune’s Naidu hospital – have been dedicated for suspected patients in the state.

In Karnataka: The state government has placed border districts of Dakshina Kannada, Kodagu, Chamarajnagar and Mysuru under novel coronavirus surveillance following three positive cases in neighboring Kerala. At Mangaluru International Airport, a health unit comprising doctors and assistants have been formed to screen passengers. An isolation ward with ten beds has been set up at the Government Wenlock Hospital to treat patients with the symptoms.

In Manipur: Five centers have been opened in different border towns of the state and at the Imphal International Airport to screen people for coronavirus.

In Mizoram: Facility opened in Mizoram where people entering through India-Myanmar border are being tested at Zokhawthar.

The test being done in India is the same one that is used for testing HIV, H1N1, dengue, polio.

So far, specimens of suspected novel coronavirus patients are tested at the National Centre for Disease Control (NCDC) in Delhi, Indian Council of Medical Research (ICMR)’s laboratories at Alappuzha, Bengaluru, Hyderabad and Mumbai, besides the National Institute of Virology (NIV), Pune. All these labs work under the guidance of NIV.

Note :: Awareness and precaution can equip better in handling the present crisis than panic.